In the current report, we describe a case of immune-mediated TTP (iTTP) in a 62-year-old man manifesting as longstanding thrombocytopenia, recurrent cardioembolic strokes, and valvular thrombogenesis over a period of 3 years. We offer educational insights regarding the identification of atypical, chronic variants of iTTP.
We report a rare case of a large prolapsed pedunculated uterine myoma measuring 15cm in its greater diameter. In order to make a surgical procedure safe and feasible, appropriate clinical predictors should be taken into account and pre- and intraoperative preparations be available to the surgeon's armamentarium.
Monoclonal gammopathy of undetermined significance (MGUS) may be associated with pathologies with severe neuromuscular manifestations such as sporadic late-onset nemaline myopathy (SLONM). We describe a difficult to diagnose case of SLNOM with marked clinical improvement after achieving gammopathy complete hematologic response.
SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID19), is associated with flares of psoriasis in patients with well-documented disease. Both viral infection and medications used for treatment, like hydroxychloroquine, were incriminated. Herein, we report the case of a 25-year-old patient who presented a first-onset guttate psoriasis following COVID19.
Pneumomediastinum is a rare complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection that has increased in incidence with the novel coronavirus disease 2019 pandemic. Although traditionally managed with conservative measures, we present the indications and methods for the first operative management of tension pneumomediastinum with concomitant SARS-CoV-2 infection.
Studies reporting S. warneri in infective endocarditis (IE) are rare. We presented a 72-year-old woman with native mitral valve S. warneri IE associated with spondylitis and cerebellar infarction. Physicians should be wary of IE and disseminated lesions when blood cultures reveal S. warneri, especially in elderlies with valvular heart disease.
Lipomatous hypertrophy of the interatrial septum (LHIAS) is a benign cardiac tumor. Differential diagnosis of LHIAS consists of atrial masses such as myxomas or lipomas. Herein, we report a 66-year-old male, admitted as a case of severe COVID-19 and was found to have a LHIAS extending to the crista terminalis.
Acute aortic dissection with coronary malperfusion is a life-threatening disease, resulting in demanding postoperative management. We report a successful insertion of percutaneous heart pump Impella through the intact true lumen in a patient with residual aortic dissection after the graft replacement and its recovery from the post-cardiotomy cardiogenic shock.
Introduction: Scrub typhus can present with audiological symptoms. Case: A pregnant mother presented with persistent fever, pneumonia and hearing loss. Investigation showed positive serology for scrub typhus. Conclusion: Clinicians must be aware of audiological presentations in scrub typhus. Possibly, permanent hearing loss was due to meningoencephalitis and hormone induced immunomodulation
Spontaneous coronary artery dissection (SCAD) is a rare condition which occurs predominantly in the postpartum period in young women. A SCAD whilst pregnant is very rare and poses significant risk to the mother and unborn child, and with minimal data on SCAD antenatally, this case highlights antepartum clinical considerations.
Papillary fibroelastomes are rare benign neoformations usually originating from the valvular endocardium, presenting with cerebral ischemia and/or myocardial infarction due to embolization from the mass. We report an exceedingly rare case of aortic wall papillary fibroelastoma simulating unstable angina, diagnosed with trans-thoracic/trans-esophageal echocardiography and CT scan and surgically successfully removed
Nephrogenic diabetes insipidus (NDI) is rarely considered against more common differentials such as diabetes mellitus in patients presenting with polydipsia and polyuria. Hypokalaemia and hypercalcemia are known to induce NDI but not much is known about hypomagnesemia. Hypokalaemia refractory to therapy should prompt consideration of hypomagnesemia.